Effect of exercise-based cardiac rehabilitation on arterial stiffness and inflammatory and endothelial dysfunction biomarkers: A randomized controlled trial of myocardial infarction patients

Background: Arterial stiffness have shown an independent predictive value for cardiovascular and allcause mortality. Objective: This study sought to evaluate the effects of an 8-week exercise-based cardiac rehabilitation program (ECR) on arterial stiffness, and on inflammatory and endothelial dysfunction biomarkers.Additionally, it was assessed two potential confounding variables, daily physical activity and dietary intake. Methods: In this parallel-group trial, 96 patients (56 +/- 10 years) were randomized to either the exercise group (EG) or control group (CG) 4 weeks after suffering acute myocardial infarction (MI). ECR consisted of 8 weeks of aerobic exercise at 70-85% of maximal heart rate during 3 sessions weekly, plus usual care. CG participants received only usual care. Baseline and final assessments included arterial stiffness through carotid-femoral pulse wave velocity (cf-PWV), inflammatory and endothelial dysfunction biomarkers, daily physical activity, and dietary intake. (ClinicalTrials.gov: NCT01432639). Results: After 8 weeks, no significant changes were found between groups in cf-PWV, inflammatory and endothelial dysfunction biomarkers, daily physical activity, or dietary intake. Excluding those patients (n = 7) who did not attend, at least 80% of the exercise sessions provided similar results, excepting a significant reduction in cf-PWV in the EG compared to the CG. Conclusions: A short-term ECR does not seem to reduce arterial stiffness and inflammatory and endothelial dysfunction biomarkers of post-MI patients under optimized medication. Nevertheless, the decrease of cf-PWV observed in the EG, when considering only those patients who attended at least 80% of exercise sessions, warrants further investigation. (C) 2015 Elsevier Ireland Ltd. All rights reserved.